<i>OPINION:</i> Social networking: An Emerging Venue for Libyan Healthcare Professionals

By Prof. Elmahdi A. Elkhammas

With the improvement in Internet access, I can see more activity from our colleagues inside Libya. Communications have been easier and the spread of social pages such as Facebook made the expression of opinion more communicable than before. Language has not been a barrier. Some have used Arabic while others have used English and a hybrid of both has been also used to communicate.

The topics of discussion have ranged from personal collaboration and social relations all the way to national healthcare issues. The role of the Libyan board of medical specialties and its leadership has been discussed in several medical groups. It was clear from the discussions that the final verdict is still out.

Physicians have felt the several other agencies need to be created to deal with medical training, accreditation, evaluations, examination, and certification issues. It was also clear that the appointment of a chairman for such important institution should be done in a transparent, open contest based on qualification, interview and recommendations.

The Libyan ministry of health and its performance has consumed a fair amount of dialogues. It is really difficult to get a consensus from these discussions for several reasons. We are not used to such debates, which in turn became a significant factor in delaying results. Lack of clear data was another point.

Dr. Rafik Elmahdawi posted recently in the Libyan Healthcare forum page the following conclusion "The evidence clearly highlights the under spending on healthcare in Libya, the presence of financial barriers to access and the inefficient and inequitable use of financial resources, as factors contributing to the poor performance of the existing Libyan healthcare system".

The above example is just one of many posts that dealt with the issue of healthcare services in Libya. Other discussions have dealt with prioritisations of concerns, medical education, advisory groups and so on. Weekly Pal talk conferences have been held with modest attendance but excellent discussion of wide topics. It dealt with many issues including the wounded and medical tourism.

Several specialty groups have opened discussion groups for their medial specialty. Such groups also have added to the quantity and quality of discussions. Some posts actually involved newer ideas involving the usage of social networking and the Internet such medical consultations. Subjects regarding medical care, exchange of medical opinions, patient confidentiality and privacy have been discussed.

The point I like to make is that the Internet has enhanced the interactions among the Libyan healthcare professionals across the globe. I have found that these discussions on these social networks have helped increase the awareness of Libyan Healthcare system and its concerns. It is an eye opener on how Libyan physicians and healthcare providers are attached to the well being of their fellow Libyans, country and their colleagues. I found the forum very useful in finding professionals who think openly and who are creative thinkers. With that being said, you also can see through the hidden agenda of others.

Unfortunately there will always be negativity or opposition in any forum. In the middle of these great discussions, there are those who voice their opinion in hindering productivity and further discussions. I have read some posts attempting to prohibit physicians living abroad to discuss leadership issues in regards to the Libyan board of medical specialties. Others have requested the return of Libyan doctors to Libya prior to indulging in any discussion related to national health issues.

It is a real issue to mix the perception of influence with freedom of expression. They are two different things. It may be difficult to accomplish a lot when you are giving your opinion from a distance. To campaign an idea or a project, you will be more effective when you are at the field of your project. On the other hand freedom of expression is simply your ability to express your ideas freely without any intimidation or fear. It should be an important item that is protected by the constitution of a new Libya. It is a little bit concerning when I hear attempts of forbidding freedom of expression from physicians who live abroad.

It has become the fashion that within five minutes of the discussion about health issues in Libya you get the yellow and some times the red card that you have committed a foul. The debater will follow by saying you are not in Libya. So why are you talking about this? This is some thing of the norm done by our colleagues who live inside Libya. I do understand that Libyans have not recovered from liberation war yet and freedom of expression is undergoing its difficult test in our culture.

The discussion some times takes a different turn but with the same message. It starts by a sudden question in the middle of discussion. Since the country has been liberated, when are you going back to Libya? It depends on your answer; you may get the red card before you can finish a sentence. Lastly the infamous blame game comes into play where the fault is placed on those abroad that did not come back and help their country.

In my view, the health system in Libya and its inadequate performance is not due to lack of good Libyan doctors inside or the lack of return of Libyan doctors from abroad. There are many deeply rooted issues. Doctors will not be able to solve such problems overnight and cannot come up with the key for a successful future health system in Libya. However, they can be part of a bigger team to steer the system into the right direction and play a major role in the execution of certain steps. The system will need a qualified, honest, team player who is a level five leader to be on the top of the pyramid. Such a leader will need full authority and accountability to act and execute the needed radical changes.

The development of the effective health system will need a board of sociologist, ethicists; health care policy makers, health management consultants, hospital managers, doctors, nurses, lawyers, religious scholars, patients and other civil institutions. Such board will study the cultural, religious, political, economic, and medical needs of Libya. They will also get the input about other health services of other developing countries. Such board needs to know the final political and economic structure of the country. It should also result in creation of a national institute for health system and may be other organizations for development and improvement.

It is very important that this board is created with adequate diversity and knowledge about Libya because if a copy and paste system is used, the end product will be a malformed healthcare system with limited effectiveness and success. An educated multidisciplinary team is one step towards the long-term development and stability of the health system in Libya. It is the corner stone for the stability of the economic and political structure too.

I am sure that health service in any country is not a single structure that is independent and isolated from the rest of the country. So Libya is no exception. We have to look into population density, transportation, salaries, education and our sociology as important components of a successful system. I have not said any thing about the other important ingredients, such medical education, allied health schools, patients' safety, accreditation, certifications, credentialing agencies, correct disease coding system, and quality agencies that are needed to support the system.

(Elmahdi A. Elkhammas, FACS and Professor of Clinical Surgery, Division of Transplantation, at the Ohio State University, Columbus, Ohio, USA. He contributed this article to The Tripoli Post. He can be reached at: elmahdi.Elkhammas@osumc.edu)

Comments

Name: abdulmoniem abdulgader	Date: 03/05/2012 19:40:40
Comment: Dear Mahdi well written article, NHS needs money, HR, well skilled mangers, advisory group, reduction of the influx of undergraduate doctors (quality not quantity) ,proper training of young doctors, transparency ,commitment,......etc in sha alla one day we will meet and share our ideas BW

Name: Mahmoud Zwawi

Date: 17/03/2012 14:45:23

Comment:
Thank you so much for a well written propasal to a fundemantle problem. This is absolutly the starting point for solving not just the health system, but many other problems that we face today and we will face tomorrow, if we do not use this approach.
Your systematic approach, takes me back to my basic and fundamentle study of Economics of Health...I have allways wondered; why we do not use the scientific method in solving our problems, but we concider our self to be scientists....
Again, thank you and please, keep up the good work.

Mahmoud

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